In a nutshell
This study compared two stem cell therapies called unmanipulated haploidentical and matched sibling donor transplant in the treatment of acute myeloid leukemia (AML). The study concluded that matched sibling donor transplant was more effective in the treatment of AML.
Some background
AML is a cancer of the white blood cells in the immune system. Stem cell transplantation is a main treatment option. Unmanipulated haploidentical stem cell transplant (Haplo-SCT) uses unmatched donor cells from close family members to replace abnormal cells with healthy cells. Fully-matched sibling donors (MSD) are a possibility, but less common. It is important to compare the safety and effectiveness of these two treatments.
Methods & findings
185 patients who received Haplo-SCT and 2469 patients who received MSD were analyzed. In total, 2010 of these patients had moderate risk (122 of Haplo-SCT and 1888 of MSD) and 644 had high risk (63 of Haplo-SCT and 581 of MSD). Patients were followed for an average of 30 months.
Overall, Haplo-SCT was associated with a 94% increase risk of acute graft versus host disease (aGVHD; when the transplanted cells attack healthy cells) and 2.56 times the risk of non-relapse mortality (death not due to disease relapse).
In patients with intermediate-risk AML, Haplo-SCT was associated with decreased leukemia-free survival and 3.3-times the risk of non-relapse mortality compared to MSD. There was an 84% increase in the risk of aGVHD with Haplo-SCT, but no increase in the risk of chronic (late-developing) GVHD.
In high-risk AML patients, Haplo-SCT was associated with a 2.2-times increased risk of aGVHD.
The bottom line
The study concluded that matched sibling donor transplant was safer and more effective treatment of AML when compared to Haplo-SCT. These outcomes were affected by risk level of AML.
The fine print
A low number of patients were used in the Haplo-SCT group which may have affected results.
Published By :
Haematologica
Date :
May 10, 2018
